Individual
SHELLY TAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2626 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1530
(859) 781-4111
(859) 441-5214
Mailing address
2626 ALEXANDRIA PIKE, HIGHLAND HEIGHTS, KY 41076-1530
(859) 781-4111
(859) 441-5214
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
05196
KY
207Q00000X
Family Medicine Physician
Primary
05196
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2019
Last updated
02/23/2024
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